Time flies, even when its not as fun as we’d prefer..

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We stopped to take a photo of a pretty flower.

Time seems to fly as we age because of the way our brains perceive time. Everything is new and unfamiliar when we’re young, so our brains process these experiences with intense focus, creating many vivid memories. Each day feels longer because we’re constantly learning and noticing details.

But as we age, life becomes more routine, and our brains don’t have to work as hard to process familiar events. This creates fewer “new” memories, making time seem to speed up.

There’s also the relative perspective. When you’re 10, a year is 10% of your life. But by the time you’re 50, a year is just 2%. As a result, each passing year feels proportionally shorter compared to the ones before.

Emotionally, it’s also tied to how we approach life. Many people reflect on missed opportunities or unfinished goals as they age, which can amplify the sensation that time is slipping away. The more we focus on the rapid passage of time, the faster it seems to move, leading to that bittersweet feeling of time flying when we’re older.

Yes! “Time flies when you’re having fun” taps into how our brains handle enjoyment and focus. When deeply engaged in something that brings us joy, we enter a ” flow state.” In this state, we’re fully immersed in the present moment, losing track of external factors…like time.

Our brains aren’t constantly clock-watching or overanalyzing; instead, they’re soaking in the experience, and before we know it, hours have passed.

It’s almost like when we’re having fun; time slips into the background because we’re more focused on the joy and connection we’re feeling. The irony is that the more we wish to hold onto those moments, the faster they seem to slip through our fingers. It’s as if fun compresses time, making it feel fleeting.

This sense of time speeding up during fun is a reminder to embrace the present fully—while it lasts!

We can’t waste time worrying about how much time we have left, nor can we become obsessed with always having fun. Life’s reality dictates that sometimes it’s challenging and far removed from our preferred reality. However, having “downtime” is crucial to embracing those special times when we engage in joyful and playful activities.

As we also know, during downtimes, we can fall into the trap of believing this is our permanent state of being. God, Life, or whatever spiritual means you surround yourself with (or not) usually provides us with the choice to make the best of every situation. However difficult it may seem, our state of mind determines the quality of our lives, regardless of the challenges. As world travelers, we are temporarily in another type of lockdown preventing us from exploring the world at this time to find even snippets of pleasure and purpose in our currently mundane state of being.

Thank you for sharing this time with us.

Be well.\

Photo from ten years ago today, September 15, 2014:

Buildings at the busy port of Boston. For more photos, please click here.

Hopeful…

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The dancers’ costumes on Royal Caribbean’s Brilliance of the Seas were elaborate for the upcoming evening’s entertainment.

This morning, for the first time in almost two months, I walked to the end of the corridor and back without getting out of breath. My legs, from lack of mobility and residual effects from the toxic drug I was taking for almost a year, are unsteady and fragile. Since today is the day I have been cleared to start walking after last Friday’s angiogram, as soon as we returned to our room after breakfast, I got up from the wheelchair and embarked on the walk.

After months of limited mobility, my legs felt weak, but this time, it was not painful, as had been the case on that drug that caused me life-threatening side effects. Little did I know, regardless of how much research I did. It was the insight of the highly trained and experienced doctors at the Cleveland Clinic that determined the reason for my breathing issues and inability to walk was caused by the drug, more so than the condition of my cardiovascular disease.

After last Friday’s angiogram, which indicated I have ongoing cardiovascular disease with one artery that is 100% blocked and not fixable. However, surgery is not indicated at this time. As for the Afib and the PVCs, it’s entirely under control with the new drug, a drug that costs over $800 a month. (As soon as I get the OK from the doctor to continue the drug, I will order it from the Canadian pharmacy for a considerably lower price).

What are PVCs? See below as described by the Cleveland Clinic at this site:

“Overview
Ventricular arrhythmias are abnormal heart rhythms that originate in the bottom chambers of the heart, called the ventricles. They can occur as a result of damage to the heart muscle from a heart attack or cardiomyopathy or in patients with hearts that seem structurally normal.

Premature ventricular contractions (PVCs) are premature beats originating in the lower chambers that may be bothersome to patients, causing symptoms such as palpitations or shortness of breath. Over time, frequent PVCs can, in some patients, cause changes in heart function.

Ventricular Tachycardia – a sustained pattern of premature ventricular contractions, which can be life-threatening.
Ventricular Fibrillation – a fast, disorganized beating of the ventricles, which quickly leads to sudden death.”

If this drug continues to control my heart rhythm, even considering its high risks, I prefer to take those risks rather than live a life limited by feeling unwell from abnormal heart rhythms.

If the doctor gives me a “good to go” confirmation on my upcoming appointment on September 27, we will excitedly and quickly plan to continue our travels. We have some ideas on what we’d like to do between October and March or April before we return to South Africa. We will share those ideas once we know more.

No, my heart health journey isn’t over. I am going to have to live with the realities of heart disease. But, many people go on to live rich and fulfilling lives with conditions such as mine. At this point, at 76 years of age, I strive for” quality of life” for whatever time I have left to explore this world with the man who’s lovingly been at my side all along.

Be well.

Photo from ten years ago today, September 13, 2014:

Tom is caught off guard while chatting with another passenger on a cruise. We can’t wait to be cruising once again. For more photos, please click here.

Its all about an apple…

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The Honeycrisp apple was created at the University of Minnesota Arboretum.

As mentioned in a post in 2012, I started eating a low-carb, grain-free, sugar-free, and starch-free diet in 2011 to reduce inflammation. Ironically, I followed a copy of the diet from researchers at Cleveland Clinic that I received from an integrative medicine doctor. Inflammation is a huge factor in diabetes, heart disease, and countless other medical conditions.

However, the damage to my arteries was already done from years of eating a high-carb, low-fat diet. There was nothing I could do to reverse it. But, perhaps I could slow down the progression. My blood sugar was high then, and insulin injections were the next step. Diabetes and heart disease were the cause of death of many of the family members on my mother’s side of the family. If I reduced my blood sugar, I felt I could live longer. I am now the matriarch of the family.

When I started this diet, I tried eating various fruits to see which raised my blood sugar, testing my blood with a test kit. In our old lives, every day before I changed my diet, I ate one Honeycrisp apple, my favorite fruit. When I ate the apple on an empty stomach, my blood sugar rose as much as if I’d eaten a candy bar.

When I discovered this, I called the University of Minnesota Landscape Arboretum across the lake from us to see if I could speak to Jim Luby, the scientist mentioned below, who developed the apple, about how much sugar is in one Honeycrisp apple. He was delighted to share the information with me.

A few hours after we talked, he called me back, explaining that one Honeycrisp apple contained the equivalent of 9 teaspoons of sugar. I was shocked it was this much. Looking online, I discovered that a single can of Coke contains 9.75 teaspoons of sugar.

Some people can eat fruit without colossal blood sugar spikes since the fiber may offset some of the response to the sugar, but I am not one of those people. Thus, my story today is about the Honeycrisp apple, which I dearly miss, having stopped eating it 13 years ago. My way of eating prevents me from needing diabetic medication.

When Tom stumbled across the following article on one of his Minnesota history sites, he sent it to me, prompting today’s story. In any case, if you can eat apples freely, these have always been my favorite. Before we left Minnesota, it cost $1 per apple at Cub Foods. I treated myself to one Honeycrisp apple daily as a midday snack each week. My mouth waters when I think of it. No wonder…sugar tastes good.

From Kare11 News in Minneapolis, here’s the article:

“Local News

The man behind the iconic Honeycrisp apple retires, passing the torch to a former student.

Jim Luby retired this summer after a 40-plus-year career in fruit breeding at the University of Minnesota Horticultural Research Center.

VICTORIA, Minn. — The man behind Minnesota’s favorite apple has decided to call it a career.

This summer, Jim Luby retired after a 40-plus-year career in apple breeding at the University of Minnesota’s Horticultural Research Center. During his career, Luby and his team created some of the tastiest apples in the country, including SweeTango, Zestar!, and their biggest success, Honeycrisp.

Luby is now passing the torch to a new generation of apple breeders led by one of his former students.

“It’s a little overwhelming,” Matt Clark said. “It’s a lot to take in.”

Clark enrolled in the master’s program at the University of Minnesota’s Applied Plant Science program in 2009. He received his degree a year later and started working on his PhD. That’s when he developed a strong appreciation for apple breeding.

“I did my PhD in the fruit-breeding lab. I studied, actually, Honeycrisp. I had an opportunity to take a deep dive into why Honeycrisp has this special gene and to be part of the legacy of Honeycrisp in Minnesota,” Clark said.

After graduation, Clark joined the department as an associate professor in their grape-breeding department to develop new wine grapes that can survive in Minnesota winters. In late 2023, Clark was asked if he would be willing to transition to Apple and take over for his former professor.

“Jim is an exceptional scientist and a wonderful person, and there are some big shoes to fill,” Clark said.

Yes, some big shoes indeed, but also an iconic apple to live up to.

“Honeycrisp was our gem. It still is, and we use it a lot in breeding, and what we’ve realized is our competition is too, because of that excellent quality, the crispiness. So, we have to step up our game to compete with everybody using Honeycrisp as a parent,” Clark said.

Clark said almost every apple they’re developing is somehow connected to Honeycrisp.

“Honeycrisp was either the grandparent, maybe even great-grandparent, or maybe even the parent to many of the apples we work with,” Clark said.

Every year, the research team plants hundreds of seeds, each slightly different. If the seed grows into a tree that can survive a Minnesota winter, the apples return to the taste test.

“It can’t taste bad, it can’t be bitter or astringent, but it might be a little tart, might be a little sweet, might have some interesting flavors, but if it’s not crisp and juicy like Honeycrisp or SweeTango, there’s no way it’s going to end up in our cooler,” Clark said.

The apples that show enough qualities to earn a spot in their cooler are then tested to see how long they can survive on the shelf.

“If they can only survive for a month and a half, then we kick them out,” Clark explained.

Very few apples meet their strict quality, taste, and shelf-life standards.

Clark said the research team usually tests out more than 10,000 combinations before finding one new variety that is good enough to release to the public.

“Apple breeding is a long-term investment,” he said. “20-ish years to develop a new variety.”

Clark said the next great apple may grow in their orchard, but he understands that discoveries take time.

“I’m not looking to retire any time soon, but if I’m here in 25 years, at the end of my career, we’re hoping to have more success stories on which we can look back.”

We are all different, and our bodies respond in various ways to foods and environmental influences. May we all strive to achieve the best possible health outcomes through good choices suitable for our personal makeup and health considerations.

Be well.

Photo from ten years ago today, September 12, 2014:

DSC03621
The indoor pool on Royal Caribbean’s Brilliance of the Seas. For more photos, please click here.

How the 9/11 attacks impacted travel in the past 23 years…

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Photo by Thomas E. Franklin/The Bergen Record/AP. Firefighters George Johnson, Dan McWilliams, and Billy Eisengrein raise an American flag at the site of the World Trade Center on September 11. Some have compared it to the iconic flag-raising at Iwo Jima, and the photo was later used as a postage stamp.

Travelers like ourselves have been significantly impacted by strict regulations at every port of entry, including more comprehensive scrutiny of checked baggage and carry-on bags. Travelers’ comments could be construed as potential indications of intent to commit a terrorist attack.

Visa restrictions made travel to certain countries time-consuming and cumbersome. Visa extensions have been challenging to obtain.

The 9/11 attacks fundamentally transformed the experience of traveling, especially air travel, in the United States and around the world. The changes were immediate and far-reaching, from tightening security measures to the psychological effects on travelers. Here’s a closer look at how 9/11 impacted travelers:

1. Tightened Airport Security

  • Creation of the TSA (Transportation Security Administration): Before 9/11, airport security was relatively relaxed. After the attacks, the TSA was established to oversee airport security, implementing stricter procedures that dramatically changed the airport experience. Travelers now had to pass through metal detectors, remove shoes, jackets, belts, and laptops, and subject their belongings to more rigorous scanning.
  • Liquid Restrictions: In 2006, further restrictions were added after a foiled plot involving liquid explosives. Travelers were limited to carrying liquids in containers of 3.4 ounces or less, all of which had to fit into a quart-sized bag. This became a routine part of air travel packing.
  • More Thorough Screening Processes: Random additional screenings, full-body scanners, and pat-downs became commonplace. Many travelers found the process more invasive, and some felt anxiety about the potential for racial profiling or being singled out for additional checks.
  • Changes in Identification Requirements: Travelers must present government-issued identification to board flights. This increased security surrounding personal information led to longer lines at security checkpoints.

2. Flight Experience and Changes in Airplane Policies

  • Restricted Cabin Access: One of the most notable in-flight changes was the introduction of locked cockpit doors. Before 9/11, it wasn’t uncommon for passengers to see the cockpit or for pilots to leave the door open during a flight. After the attacks, airlines reinforced doors to prevent access to the cockpit, ensuring only authorized personnel could enter.
  • In-Flight Protocol: Flight attendants and crew members became more vigilant in identifying potential threats. Passengers were also encouraged to report any suspicious behavior. The sense of camaraderie among passengers shifted, as many felt a new level of responsibility in ensuring the safety of their fellow travelers.

3. Psychological Impact on Travelers

  • Fear of Flying: In the months and years following the attacks, many people developed a fear of flying. Anxiety about potential hijackings or terrorist attacks made air travel more stressful. Some people opted for alternative means of travel, such as driving or taking trains, while others avoided travel altogether.
  • Heightened Awareness: Even frequent travelers became more hyper-aware of their surroundings at airports and on planes. The once-carefree attitude of going through an airport was replaced with a constant sense of vigilance. Over time, this created a new kind of travel culture where security was always on our minds.
  • Impact on Muslim and Middle Eastern Travelers: Unfortunately, Muslim travelers, as well as individuals perceived to be of Middle Eastern descent, faced an increase in racial profiling and discrimination at airports. Many were subjected to additional screenings and questioned more often, which added stress and frustration to the travel experience. Some even reported avoiding air travel due to the fear of being singled out.

4. Changes in International Travel

  • Stricter Visa Requirements: The U.S. government imposed more stringent visa requirements for people traveling to the United States, especially from certain countries. Many countries followed suit, tightening their own immigration and entry policies. The introduction of biometric passports, increased background checks, and the requirement for more detailed travel histories became standard.
  • Heightened Border Security: Security measures at international borders were also reinforced. Passing through customs and immigration became lengthier, with more in-depth questioning and screenings for travelers entering or leaving the U.S.

5. Economic Impact on the Travel Industry

  • Airline Industry Losses: In the aftermath of 9/11, airlines suffered massive financial losses. Thousands of flights were grounded, and the entire airspace was closed for several days. The reduced demand for air travel led to layoffs in the airline industry and contributed to the bankruptcy of several major airlines over the years. Many smaller travel agencies also struggled to recover from the downturn.
  • Rise in Airfares and Travel Costs: As security and insurance costs increased, airlines began raising ticket prices to cover the added expenses. Fees for checked baggage, in-flight meals, and other services became more common, making travel more expensive.
  • Decrease in Leisure Travel: Many travelers, especially those for leisure, hesitated to fly in the months following the attacks. Fear of future incidents and the hassle of going through enhanced security discouraged some from traveling unless necessary. The travel industry had to work hard to regain public confidence.

6. Adaptation and Resilience

  • Return to Travel: Over time, people began to adjust to the “new normal” of air travel. Though the changes were significant, most travelers gradually accepted the heightened security as a necessary part of flying. By the mid-2000s, travel volumes primarily recovered, although the experience had permanently shifted.
  • Focus on Preparedness: For some travelers, the changes brought a heightened sense of preparedness. Many became more aware of emergency procedures, paid more attention during safety briefings, and learned to navigate airport security efficiently. Some even carried emergency supplies or developed mental strategies to cope with anxiety.

While the overall experience of traveling, especially by air, became more stressful and time-consuming, 9/11 also introduced a new sense of unity and responsibility among travelers. The shared experience of heightened security brought people closer, and many found ways to navigate the challenges with resilience and understanding.

We continue to pray for our country’s and its citizens’ safety in challenging times.

Be well.

Photo from ten years ago today, September 11, 2014:

DSC03571
On this date, Tom and I enjoyed dinner at Giovanni’s specialty restaurant, where we ate a fabulous meal aboard Royal Caribbean Brilliance of the Seas. For more photos, please click here.

A story from ten years ago…We haven’t changed much…

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In many countries, we don’t see this much use of color in the buildings, which are often brick and stone from centuries ago. Much of Reykjavik, Iceland, has been built over the past 50 years.

On this date, ten years ago, we were on a ship-arranged tour in Reykjavik, Iceland. We opted for the full-day off-road adventure in a large, giant-tired land and water vehicle. It was a pricey tour, but with only eight passengers, it was perfect. Unfortunately, it rained the entire day. But neither of us hesitated to exit the vehicle to revel in Iceland’s wonders, ending up soaked but exhilarated.

As I reviewed the post from ten years ago, I was reminded of our enthusiastic emotional state and the joy we were experiencing in year two of our world travels. Thus, unlike anything we’ve done in the past, I am sharing the verbiage we wrote on September 10, 2014. You can see the entire post here.

So, here we go, the post we wrote ten years ago today:

“Happiness is fleeting. At times, it wraps around our hearts during a special moment or entirely surrounds us on a day when everything in the world is right. We experienced our fair share of those special moments in our old lives. However, the challenges of everyday life are often imposed upon maintaining a perpetual state of contentment.

A pipe broke, spewing water all over the basement. An error on our cable bill threw us into a frenzy to correct it, perhaps leaving us frustrated and angst throughout the day. Day-to-day life has many challenges, often entirely out of our control or beyond our realm of responsibility.

Of course, the greatest angst of all is when we do make a mistake, an oversight, or an unintended spontaneous blurb that may hurt the feelings of a loved one or friend. It is during these times that we may feel as if it will never be right again, and happiness becomes a fleeting memory.

When we left life in Minnesota almost two years ago (October 31, 2012), we had no expectations of happiness being a daily state, of being consistent, or even somewhat dependable.

After being ill for many years and suddenly becoming well in August 2011, we both felt a sense of urgency to take advantage of my renewed health by living “outside the box” for as long as health allowed. It could all change in a day, a week, or a month. We chose happiness as a way of life.

We asked ourselves how we could best achieve such a state of happiness. The answer in our hearts was being free of most responsibilities, certain obligations, and the tasks of maintaining a house, a car, and a lawn.

We were left with only the responsibility of financial matters, planning and following our travel schedule, and, of course, to one another.

Communicating with our faraway loved ones has been nothing but pure joy. Yes, we occasionally feel a tinge of guilt for leaving everyone. But it doesn’t consume us when we’re committed to loving them all with open hearts, not guilt or sorrow, both of which impede happiness. They know we love them.

Ah, the old clichés. Terms such as “live life when you can,” “live life on your terms,” or “live your dreams ” are often espoused when speaking to others, but we seldom adopt these principles for ourselves.

So, here we are, “living life on our terms,” pleasing some, frustrating others, and leaving some curious about how we could dispose of everything we knew and love to make a life of happiness.

Whatever comes, we’ve been exquisitely happy these past almost two years. We often look at one another with expressionless faces, eyes locked upon each other, when suddenly, a wide-tooth-baring grin, almost from ear to ear, fills our aging faces with pure and simple happiness.

“Pinch me,” I often say. “Is this well-organized, meticulously planned, and executed like ours?” Yep. That’s us.  And for however long it lasts, we’re grateful.

We love it now as much as the first day we left the US on January 3, 2013, after spending two months back and forth between Arizona and Nevada, planning our final details. In many ways, we love it more now, with the experience under our belts, the kinks worked out, and the fear all but gone.

I no longer fear flying in tiny airplanes, scorching hot weather without AC, lack of screens on windows, scary bugs, rough conditions, or rough roads. Laying it in God’s hands, coupled with common sense to keep us safe, we carry on.

Today, we share the last of our photos from Monday’s Iceland tour. Monday night, we departed Iceland and will be out to sea for five days. I won’t have WiFi until Sunday morning at 8:00 Eastern time when we dock in Boston. Please email me if anyone needs to reach me, and I’ll check daily.

Posts and photos will continue daily when we’re out at sea, during which I’ll use Tom’s computer with the ship’s slow WiFi signal. In the meantime, we’ll continue to have fun, cherishing each moment, every week, every month, and every year of happiness for however long we’re gifted with the desire to continue on.”

We haven’t changed much, have we? Regardless of how challenging the issues we face, we always strive to be challenged and fulfilled in life. Thank you for being here with us.

Be well

Photo from ten years ago today, September 10, 2014:

Icelanders believe Leif Erickson, represented in this statue, discovered America, not Christopher Columbus. For more photos, please click here.

Have to start living again…Cancelled dinner plans…

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We enjoy spotting gorgeous roses in many countries.

We had to cancel dinner plans for the second time with friends Carol and Mark while we were in Cleveland. The first time was on Wednesday when, shortly before dinner, we went to the emergency room when I had horrific high blood pressure and heart rhythm issues after stopping the drug Flecainide six days earlier. Today is the second time.

Now, on the latest drug, Multaq, I am suffering from horrible side effects after three days on the drug. I can barely move. My arms and legs are weak and painful, and periodically, I find myself out of breath. I am determined to keep taking the drug until I’ve used the entire month’s supply.

After already trying five other drugs over the past few years with similar side effects that never stopped after continued use, I will be out of options. I’ll have no other choice than to take my chances and not treat my irregular high blood pressure and heart rhythm irregularities. That’s the way it is. In the meantime, nothing is required of me but to feel better. No place to go. No one to see. No obligations.

Between us, we’ll manage to make dinner each night, or, when necessary, we can order delivery, which is easy, although expensive. I found a healthy Asian delivery restaurant that makes fantastic bowls with kale, kimchee, lots of veggies, and chicken or beef. These are much healthier than Chipotle bowls. Tom likes Reuben and hot corned beef sandwiches and fries from a local deli.

We’ve been ordering enough for two nights, running about $100 with free delivery (free through Amazon Prime), tax, and tip. This averages $50 a night, more than buying groceries but less than dining out. We can make two to three dinners with what we have on hand, which we ordered from Costco, and order out for the rest. This will average about $300 per week, $100 more than if we cooked nightly.

With the hotel’s complimentary breakfast, which we partake in daily, Tom often doesn’t feel hungry for dinner since he eats more filling food than I do. But I always need to have a meal in the evening. It will all work out well.

Today, I considered not writing a post due to my extreme weakness and need to lie down. But, as patient as all of our readers have been, I at least wanted to post something and let you know that we are thinking of you, regardless of our current challenges.

Yesterday, our friends Marylin and Gary called to see how we’re doing after they’ve been in Marloth Park for many weeks. Several batches of family and friends visited one after another while they stayed in Louise’s house. It was delightful to hear how much fun they had these past few months, with one fantastic adventure after another. This only enhances our desire to return to Marloth Park once the weather cools down, closer to winter.

That’s it for today, folks. We’ll be back again soon.

Be well.

Photo from ten years ago today, September 9, 2014:

In many areas of Iceland, steam rose from the ground due to the activity of the tectonic plates. Overall, Iceland is an island where earthquakes and volcanic eruptions are expected. For more photos, please click here.

Finally, we’re back!…A diagnosis…Huge savings on prescription drugs!…

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A storm was on the horizon over the Indian Ocean.

I don’t know where to begin. It’s been an interesting and rough past several days since we went to the ER at Cleveland Clinic on Wednesday when I  had another concerning spike in blood pressure. 220/122, which felt like “birds flying around in my chest,” while I was breathless and could barely walk.

It has been six days since I stopped taking the dangerous drug Flecainide, and the symptoms the drug supposedly covered returned with a vengeance. Since no alternative drug was to be prescribed until after I had the angiogram on Friday and after I was required to stop taking Eliquis, the vital blood thinner to prevent strokes, the ER cardiologist felt I needed to be closely monitored in the hospital until the test was conducted. I was returned to Eliquis and some form of heart rhythm drug that would be safer.

A few days earlier, the electrophysiology cardiologist, Dr Keogh, insisted that l immediately stop taking the drug Flecainide, which can be deadly for heart surgery patients such as me. Below, I will list the discoveries made this past week since my appointments began at the Cleveland Clinic, many shocking to us after all we’ve been through with my health issues over the past few years.

  1. I do not have severe mitral and tricuspid valve regurgitation, which three cardiologists diagnosed in three different countries after three echocardiograms. Thus, I do not need valve surgery at this time based on the comprehensive echocardiogram I had at the Cleveland Clinic. My valves are moderate, but that could change to severe in months or…if I’m lucky, not at all. Of course, we’re thrilled I don’t need the surgery now. But we’re highly frustrated to have been misdiagnosed by three doctors, resulting in considerable worry and concern. At the same time, we’ve waited for my appointments at Cleveland Clinic since making the appointments last March.
  2. The drug Flecainide was prescribed without hesitation by the three cardiologists, as mentioned earlier, with no consideration for the fact that this drug is toxic for patients, let alone anyone who had previous CABG surgery (cardiac bypass surgery). This toxicity caused me to be unable to walk and be out of breath from walking a short distance. Why didn’t they know this?
  3. After the angiogram on Friday, it was discovered that one of my bypassed arteries had failed, and my arteries are too small to add a stent. Instead, when and if I have bad symptoms, I’ll have to have another bypass surgery. Time will tell.

I was started on a new drug on Friday night, Multaq, which also has serious side effects but is safer than Flecainide for my situation. The bad part of this drug is that in the US, the drug costs as follows:

$850 for a 30-day supply

  • Multaq 400 mg oral tablet costs around US $850 for a supply of 60 tablets, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans. The recommended dose is 60 tablets a month, 400 mg., taken with breakfast and again with dinner since it is necessary to take it with food to avoid severe stomach upset.
  • Fortunately, I found the drug at PharmStore.com, where I can buy 180 tablets for US $648.99. At this point, I am taking only one tablet a day, cut in half, which the doctors said was fine as long as I take only as much as I need to reduce the side effects and work for me. Currently, I am having harsh side effects, but they should improve in months to come. I’ll be thrilled if I can avoid doubling the dose to prevent more side effects.

4. The doctors (I have four cardiologists) suggested we stay here for the next six to eight weeks while I become accustomed to the drug to control my heart rate, blood pressure, Afib, and PVC symptoms. If it doesn’t work, they’ll have to switch me to an alternative with only a few remaining that I can take. In the past, I’ve already tried five drugs, resulting in intolerable, life-changing side effects. Quality of life is crucial. I am not willing to be sleepy all day or be unable to breathe or walk. Nor do I want to be going to ERs with outrageously high blood pressure, heart rate, and arrhythmias.

It’s a convoluted series of issues, none of which I can avoid over the long haul. But, to be able to avoid surgery and a long recovery right now is a huge relief, and I chose not to worry about what’s to come in the future. We are both excited to return to our world travels in the next few months. We’re contemplating several options, including our next journey to South Africa when it cools down.

Again, thank you for all of your concern and warm wishes. It has meant so much to both of us over these many months and kept me busy on my phone while I was lying in a hospital bed for the past three days and nights.

Be well.

Photo from ten years ago today, September 8, 2014:

The Videyjarstofa house, where a restaurant is now located, was built in 1755 and is thus the first construction made of stone and cement in the country. The church was consecrated in 1774 and is still the second oldest one. The island became the seat of the first Icelandic treasurer and later the first Icelandic sub-governor. At the beginning of the 20th century, the country’s first harbor for ocean-going vessels was built on the eastern part of the island, from which a hamlet developed.For more photos, please click here.

A harsh reality…

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Sunset with an unusual shot in Vancouver, British Columbia.

They say doctors are “practicing” medicine. It’s not an exact science. My use of a prescribed dangerous drug has clouded the answers to the cardiac condition that I was prescribed in 2023. Some tests have to be redone now that I am off that drug. Thus, the process of getting definitive answers is prolonged over the next several weeks while more tests are performed.

Being patient has never been easy for me, although I have learned to monitor my response to my lack of patience by being diplomatic. It is rarely beneficial to exhibit adverse reactions to waiting for answers. Of course, I couldn’t be in a better place to seek those answers.

In this case, the required patience isn’t regarding the healthcare professionals handling my case. It’s regarding this Black Box drug I’ve been taking for the past 11 months which was condoned and prescribed by three cardiologists in three different countries, not here at the Cleveland Clinic.

Sure, I need answers as to the condition I am suffering from, which is looking more and more like an electrical problem with my heart, not a plumbing problem, which I’ve described below.

The cardiovascular system can be compared to a house’s electrical and plumbing systems. Each plays a crucial role in keeping the system functioning correctly, and problems in either area can lead to severe issues.

Electrical System (Heart’s Electrical Activity)

The heart’s electrical system controls the rhythm and rate at which your heart beats. This system generates and conducts electrical signals that trigger heartbeats, ensuring blood is pumped efficiently. Here are some key points:

  • Components: The electrical system includes the sinoatrial (SA) node, atrioventricular (AV) node, and a bundle of His and Purkinje fibers.
  • Function: The SA node acts as a natural pacemaker, creating electrical impulses that spread through the heart, causing it to contract and pump blood.
  • Issues: Problems with this system can lead to arrhythmias (irregular heartbeats), tachycardia (fast heartbeat), or bradycardia (slow heartbeat). For example, atrial fibrillation (AFib) is a standard electrical issue where the heart beats irregularly and inefficiently.

Plumbing System (Blood Vessels and Flow)

The cardiovascular system’s plumbing involves the heart’s structure and the network of blood vessels (arteries, veins, and capillaries) that carry blood throughout the body. Here’s how it works:

  • Components: The heart’s chambers (atria and ventricles), valves, and the vast network of arteries, veins, and capillaries.
  • Function: The heart pumps oxygenated blood through the arteries to the rest of the body, and returns deoxygenated blood through the veins to be reoxygenated in the lungs.
  • Issues: Plumbing problems often involve blockages, leaks, or malfunctions in the blood vessels or heart valves. Common issues include coronary artery disease (blocked arteries), heart valve disorders (e.g., stenosis or regurgitation), and heart failure (where the heart doesn’t pump blood effectively).

In Summary

  • Electrical issues involve the heart’s rhythm and rate, and problems here can lead to irregular or ineffective heartbeats.
  • Plumbing issues involve the blood vessels and the heart’s structure. They affect blood flow, leading to blockages, leaks, or inefficient pumping.

Both types of issues can have serious consequences, but they originate from different aspects of the cardiovascular system’s function.

After Friday’s upcoming angiogram, which tests the heart’s plumbing, we may be able to narrow down my problem to either electrical or plumbing or, in the worst-case scenario, both. But at this point, I am hopeful it’s only electrical, which is most likely based on new and upcoming tests.

In any case, being off that drug has changed everything. I can breathe better, walk better, and sleep through the night. I hope my remaining issues can be addressed and resolved so we can continue our travels.

Be well.

Photo from ten years ago today, September 4, 2014:

There was no post on this date ten years ago due to a travel day.

More tests this morning…Feeling much better and extremely hopeful…

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Stonehenge..

Is it possible I won’t have to have another open heart surgery? Based on test results so far, it’s looking like I may not need to. But the biggest test is upcoming on Friday, and the one I am dreading the most is a cardiac angiogram. It’s an unpleasant test. I’ve had it twice in the past.

If I could be anesthetized during the test, I wouldn’t mind so much, but this test is done while the patient is awake. The idea of being awake again for yet another one of these tests while they cut a hole in my groin or wrist, which they will have numbed with lidocaine, is a bit intimidating to me. Also, a mild sedative is usually provided.

There is no pain during the test, but the concept of a thin wire being threaded into my heart makes me cringe a bit. For some patients, this may not be an issue. Of course, it’s important to discuss concerns with the physician and the anesthesiologist who will be present during the test.

An angiogram is a medical imaging procedure used to visualize the inside of blood vessels and organs, primarily to identify and diagnose issues related to blood flow, such as blockages or abnormalities in arteries and veins. The procedure involves using X-rays and a contrast dye injected into the bloodstream, allowing doctors to see the blood vessels more clearly on the X-ray images.

Angiograms are crucial tools in diagnosing a range of cardiovascular conditions. When a patient experiences chest pain, shortness of breath, or unexplained fatigue, doctors may suspect an issue with the heart or the blood vessels supplying it. An angiogram can help determine whether there are any blockages or narrowing of the coronary arteries, which supply blood to the heart muscle. This is particularly important in diagnosing coronary artery disease (CAD), a leading cause of heart attacks.

It was in South Africa in February 2019 that I had an angiogram that determined that I needed immediate open heart surgery, which is called CABG (yep, pronounced “cabbage”), which is a “coronary artery bypass graft.”

Angiograms can examine blood vessels in other parts of the body, including the brain, kidneys, legs, and heart. For instance, a cerebral angiogram can help identify issues such as aneurysms (weak spots in blood vessels that can rupture) or arteriovenous malformations (abnormal connections between arteries and veins), leading to severe complications if not treated.

Undergoing an angiogram involves several steps, beginning with preparation. Patients are typically advised to avoid eating or drinking for several hours before the procedure. Once at the hospital, they may receive a mild sedative to help them relax.

The procedure usually occurs in a catheterization lab, a specialized room equipped with imaging equipment. The patient lies on a table, and the area where the catheter will be inserted is numbed with a local anesthetic. The catheter, a thin, flexible tube, is inserted into a large artery, usually in the groin or wrist, and carefully threaded through the blood vessels to the area of interest.

Once the catheter is in place, the contrast dye is injected through it. As the dye travels through the bloodstream, it highlights the blood vessels on the X-ray images, allowing doctors to see any areas of concern. Patients may feel a brief warm sensation or a flush as the dye is injected, but this is typically mild and short-lived.

The entire procedure usually lasts about 30 to 60 minutes, though it can vary depending on the case’s complexity. After the angiogram, the catheter is carefully removed, and pressure is applied to the insertion site to prevent bleeding. Patients are typically monitored for a few hours to ensure no complications before they can go home, though some may need to stay overnight.

Like any medical procedure, an angiogram carries some risks, though they are generally low. Potential complications can include allergic reactions to the contrast dye, bleeding or bruising at the catheter insertion site, and, in rare cases, damage to the blood vessels or kidneys. However, the benefits of accurately diagnosing potentially life-threatening conditions often outweigh these risks.

Patients need to discuss their medical history with their doctor before the procedure, particularly if they have allergies, kidney problems, or are pregnant, as these factors can influence the safety and approach of the angiogram.

Following an angiogram, the results will help guide the next steps in a patient’s care. If a blockage or narrowing is found, doctors may recommend further treatments such as angioplasty (a procedure to open the narrowed arteries) or surgery. Sometimes, the angiogram might lead to lifestyle recommendations, such as dietary changes, exercise, or medications to manage the underlying condition.

Overall, an angiogram is a vital diagnostic tool in modern medicine. It provides detailed insights into blood vessels’ health and helps inform treatment decisions that can save lives. This procedure combines advanced technology with expert medical care to ensure the best possible outcomes for patients.

This morning, after being off the high-risk Flecainide for five days, I had a repeated stress test. I completed the test but am not confident that the results were ideal based on the conversations between the three technicians performing the test. But I could be wrong. Within the next few hours, after the doctor has accessed and documented the test results, I’ll be able to see his assessment in My Chart. I wait patiently.

After Friday’s angiogram, I’ll know even more. We’ll continue to post results.

Be well.

Photo from ten years ago today, September 3, 2014:

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Tom, at Stonehenge, England. It was a rainy day, and we were soaked, but we took many photos. For more photos, please click here.

Was incompetency the issue?…Using delivery services worldwide..

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The region of Normandy is rich in history and charming for its appealing French architecture of the century’s past.

A few nights ago, we placed a food order with DoorDash, an often-used delivery service that includes ordering from restaurants, pharmacies, retail shops, pet supplies, beauty products, and more. We have nothing negative to say about DoorDash since we’ve always had good experiences using their services, along with GrubHub or Instacart, to name only a few such delivery services.

When we placed the Chinese food order on Friday evening, when our delivery time passed, I called the driver to discover he’d delivered the food to the wrong Intercontinental Hotel, Cleveland Clinic. There are two such hotels near the Cleveland Clinic, including the one where we’ve been staying, a few blocks away, the Intercontinental Hotel Suites, Cleveland Clinic. It was an easy mistake to make.

When I called the driver, he said he was already 25 minutes away but would return to collect the food and bring it to our hotel. An hour passed, and the food wasn’t delivered. He wouldn’t answer his phone. When I called the hotel where the food was delivered, they said they couldn’t get it to us.

We were hungry and didn’t care for a refund, so Tom left on foot to walk to the other hotel to collect our food. Fortunately, he managed to catch a Cleveland Clinic shuttle to return to our hotel. Surprisingly, the food, two hours later, was a little warm. We reheated our plates in the microwave, and by 8:00 pm, we could have dinner.

This is not to say delivery companies are incompetent. This was the first time we’ve ever had an issue, and we won’t hesitate to use delivery services in the future. It was more of a fluke. The only disappointment was that the driver promised to bring us the food but chose not to.

Many delivery companies are international, which we’ve also used when available in other countries. However, to ensure accuracy, we use them more often in the US and English-speaking countries, and when ingredient specifications may not be clearly defined for my way of eating.

Navigating the World of Food Delivery: A Journey Across Continents

As the sun dips below the horizon and the city lights begin to flicker, a universal hum unites people from New York to New Delhi, from Paris to Tokyo—a craving for comfort, convenience, and connection. In the modern world, where time often feels like the most precious currency, food delivery services have emerged as the bridge between our busy lives and the nourishment we seek. This phenomenon, while global in reach, carries distinct flavors and emotions that vary as widely as the cuisines it delivers.

The United States: Convenience at Your Doorstep

Food delivery has become synonymous with convenience, speed, and choice in the United States. The sheer variety of options is staggering. Whether craving a greasy cheeseburger at midnight or a vegan quinoa salad during a lunch break, services like Uber Eats, DoorDash, and Grubhub fulfill almost any culinary wish. The ease with which one can browse, select, and order a meal with just a few taps on a smartphone is a testament to the country’s love affair with instant gratification.

But beneath this veneer of convenience lies a deeper psychological layer. For many, ordering food is not just about satisfying hunger—it’s about comfort, especially in times of stress or isolation. Selecting a meal, waiting for its arrival, and finally indulging in it can be a soothing ritual, particularly in a society where people often feel disconnected from the traditional cooking at home. The delivery person becomes a temporary link to the outside world, a reminder that even in solitude, there’s a connection to the broader community.

The pandemic amplified this dynamic. With lockdowns forcing people indoors, food delivery services became a lifeline for many. Not just a way to avoid cooking but a small luxury—a way to break the monotony of endless days spent at home. The arrival of a delivery driver was sometimes the most human interaction people had in a day. It’s a service that offered a sense of normalcy in a time when nothing felt normal.

Europe: A Blend of Tradition and Modernity

In Europe, the relationship with food delivery is a bit more complex. On one hand, cities like London and Paris have embraced services like Deliveroo and Uber Eats with the same enthusiasm seen across the Atlantic. But on the other hand, there’s a deep-seated appreciation for traditional dining experiences. The leisurely meal at a café and the ritual of shopping for fresh ingredients at a market are cultural staples many Europeans are reluctant to abandon.

In cities like Rome or Barcelona, food delivery often feels like a convenience reserved for the rushed, the overworked, or the young urbanites who prioritize efficiency over tradition. Yet, there’s an exciting fusion happening. High-end restaurants that once resisted the idea of takeaway now offer gourmet meals delivered to your door, complete with detailed instructions on how to plate the dish just as the chef intended. This blend of old-world charm and modern convenience reflects Europe’s ability to adapt while still holding on to its roots.

Food delivery is still a novelty and unnecessary for many Europeans, especially those in smaller towns or rural areas. The psychological relationship with food is steeped in the idea of communal dining, of meals being an event rather than just sustenance. Therefore, while the convenience of food delivery is appreciated, it is not yet a replacement for the deep cultural significance of cooking and sharing food.

Asia: A Symphony of Flavors at Your Fingertips

In Asia, food delivery has taken on a life of its own, shaped by the region’s rich culinary diversity and the fast-paced nature of its urban centers. In cities like Bangkok, Seoul, and Tokyo, food delivery isn’t just about convenience—it’s an integral part of daily life. The options are as varied as the cultures within Asia itself. One can order anything from sushi to street food-style snacks, all with the expectation of speed and precision.

In many Asian countries, the rise of food delivery services has also sparked a unique cultural shift. Traditionally, meals were a family affair, prepared at home with care. However, the demand for quick and easy meal solutions has surged as more people migrate to cities and adopt hectic lifestyles. Apps like GrabFood in Southeast Asia and Meituan in China have revolutionized how people think about food, making it possible to access a vast array of dishes with minimal effort.

Yet, this shift comes with its own set of psychological implications. The convenience of food delivery can sometimes lead to a sense of disconnection from the act of cooking and the rituals surrounding meal preparation and consumption. In societies where food is deeply intertwined with identity and tradition, this can create a subtle but significant tension between modern convenience and cultural preservation.

A Global Appetite for Connection

Across the globe, food delivery services have become more than just a way to satisfy hunger. They reflect our collective need for connection, comfort, and control in an overwhelming world. Whether it’s the convenience of a late-night burger in New York, the fusion of tradition and modernity in Paris, or the symphony of flavors in Tokyo, food delivery offers a unique window into how we navigate our lives and identities.

Ultimately, no matter where we are, ordering food is about more than just eating. It’s about the emotions that come with it—the anticipation, the satisfaction, the comfort. And in a constantly changing world, that’s something we can all relate to, no matter where we call home.

Tomorrow, after we move to our new location, only blocks away, we’ll place a to-be-delivered grocery order since we’ll have a fully equipped kitchen where we can again prepare easy meals. It will be nice to get settled.

Happy September! To our friends and family in the US, have a safe Labor Day weekend!

Be well.

Photo from ten years ago today, September 1, 2014:

The Normandy American Cemetery and Memorial in Normandy, France. For more photos, please click here.